Effectiveness of non-pharmacological and pharmacological interventions on delirium duration in older adults with delirium: a systematic review and meta-analysis of randomised controlled trials.

Background Delirium is a severe neuropsychiatric syndrome common in older adults and linked to adverse outcomes, especially when prolonged and in the presence of cognitive deficits. While preventive multicomponent strategies are well established, the effectiveness of interventions for treating delir...

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Published in:Age & Ageing Vol. 55; no. 4; pp. 1 - 12
Main Authors: Sánchez, Alba, Sawant-Uttekar, Pallavi, Pribadi, Afifah N, Heinen, Darlene, Thomas, Christine, Arnim, Christine von, Kühnle, Julia, Kreisel, Stefan Henner, Hewer, Walter, Fath, Björn
Format: Article
Published: Oxford University Press / USA Apr2026
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Online Access:View this record in EBSCOhost
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      dt: Apr2026
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        10.1093/ageing/afag085
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        atl: Effectiveness of non-pharmacological and pharmacological interventions on delirium duration in older adults with delirium: a systematic review and meta-analysis of randomised controlled trials.
      aug:
        au:
          Sánchez, Alba
          Sawant-Uttekar, Pallavi
          Pribadi, Afifah N
          Heinen, Darlene
          Thomas, Christine
          Arnim, Christine von
          Kühnle, Julia
          Kreisel, Stefan Henner
          Hewer, Walter
          Fath, Björn
        affil:
          Department of Social and Preventive Medicine, University of Potsdam, Potsdam, Brandenburg, Germany
          Klinik für Geriatrie, Marien Hospital Stuttgart, Stuttgart, Germany
          Department of Geriatric Psychiatry and Psychotherapy, Klinikum Stuttgart, Stuttgart, GermanyDepartment of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
          Department of Geriatrics, University Medical Center Göttingen, Gottingen, GermanyGerman Center for Cardiovascular Research (DZHK), Göttingen, Germany
          Department of Geriatric Psychiatry and Psychotherapy, Klinikum Stuttgart, Stuttgart, GermanyDepartment of Geriatrics, University Medical Center Göttingen, Gottingen, GermanyGerman Center for Cardiovascular Research (DZHK), Göttingen, Germany
          Department of Psychiatry and Psychotherapy Bethel, Division of Geriatric Psychiatry, Evangelisches Krankenhaus Bielefeld, Bielefeld, Germany
          Klinikum Christophsbad, Clinic for Geriatric Psychiatry, Göppingen, Germany
          Department of Geriatric Psychiatry and Psychotherapy, Klinikum Stuttgart, Stuttgart, GermanyKlinikum Christophsbad, Clinic for Geriatric Psychiatry, Göppingen, Germany
      su:
        Old age
        Disease duration
        Research funding
        Treatment effectiveness
        Meta-analysis
        Descriptive statistics
        Chi-squared test
        Systematic reviews
        MEDLINE
        Delirium
        Medical databases
        Length of stay in hospitals
        Confidence intervals
        Psychology information storage & retrieval systems
      sug:
        subj:
          Old age
          Disease duration
          Research funding
          Treatment effectiveness
          Meta-analysis
          Descriptive statistics
          Chi-squared test
          Systematic reviews
          MEDLINE
          Delirium
          Medical databases
          Length of stay in hospitals
          Confidence intervals
          Psychology information storage & retrieval systems
      keyword:
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        delirium
        delirium duration
        https://dx.doi.org/10.1093/ageing/afag085
        inLanguage:en
        meta-analysis
        non-pharmacological interventions
        older adult
        older adults
        pharmacology
        pharmacotherapy
        publisher:Oxford University Press
        randomization
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41965252/
        systematic review
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        delirium
        delirium duration
        https://dx.doi.org/10.1093/ageing/afag085
        inLanguage:en
        meta-analysis
        non-pharmacological interventions
        older adult
        older adults
        pharmacology
        pharmacotherapy
        publisher:Oxford University Press
        randomization
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41965252/
        systematic review
      ab: Background Delirium is a severe neuropsychiatric syndrome common in older adults and linked to adverse outcomes, especially when prolonged and in the presence of cognitive deficits. While preventive multicomponent strategies are well established, the effectiveness of interventions for treating delirium in older adults remains unclear. Objective To evaluate the efficacy of non-pharmacological and pharmacological interventions for treating delirium after onset in older adults (≥65 years), with delirium duration as primary outcome and length of stay as secondary. Methods We conducted a systematic review and meta-analysis of randomised controlled trials evaluating interventions for treating delirium across settings, excluding ICU-only studies. MEDLINE, Cochrane, Web of Science and PsycINFO were searched through October 2024. Comparators included usual care, placebo or other drug treatments. Random-effects meta-analyses with subgroup analyses by setting and drug type were performed. Sensitivity analyses excluded high risk-of-bias studies. PROSPERO registration: CRD42024500346. Results Seventeen trials (3765 randomised patients) were included. Non-pharmacological multicomponent interventions (k = 6, n  = 2634) reduced delirium duration by −1.79 days [95% confidence interval (CI): −3.08 to −0.51] compared to usual care, with high heterogeneity (I  = 97%). Effects were significant in medical and mixed settings. Pharmacological interventions (k = 7, n  = 259) showed no significant effect (mean difference: −0.58 days; 95% CI: −1.24 to 0.08), and subgroup analyses revealed no differences. Neither intervention type significantly reduced length of stay. Conclusions Non-pharmacological multicomponent interventions may reduce delirium duration in older adults, but evidence is limited by heterogeneity and the few studies focused on treatment. Pharmacological and single-component interventions showed unclear benefit, underscoring the need for more high-quality trials in this population.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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